Physical activity is effective in preventing and treating cardiovascular disease (CVD). However, high-level physical activity may pose potential health risks. An elevated resting heart rate is indicative of poor cardiovascular function, yet the safety of physical activity in individuals with high resting heart rates remains unclear. This study aimed to investigate the joint association of resting heart rate and physical activity with CVD risk to provide evidence for individualized exercise guidance.

This study included 5 672 middle-aged and older adults from the China Health and Retirement Longitudinal Study database. Generalized additive models were employed to explore the independent and joint associations of resting heart rate and physical activity with CVD risk. Multiple logistic regression was further used to examine their correlations, while three-dimensional surface plots and two-dimensional slice plots at fixed resting heart rate levels were generated to visualize the nonlinear associations.

A significant nonlinear interaction was observed between resting heart rate, physical activity, and CVD risk (P for interaction <0.001). Compared with the reference group (normal resting heart rate and moderate physical activity), individuals with a resting heart rate >100 beats per minute and low physical activity had the highest risk of CVD (OR=6.223). Among those with high resting heart rate, moderate physical activity was associated with a possible increase in risk (OR=2.059), whereas high physical activity showed no statistically significant association with CVD risk (OR=0.956).

In individuals with a high resting heart rate, high-level physical activity is not associated with an increased risk of CVD. Increasing physical activity represents a universally applicable, low-cost, and effective health promotion strategy.

To analyze the trends in disease burden of Alzheimer's disease and related dementias (ADRD) attributable to smoking in China from 1990 to 2023, and to provide evidence to inform prevention and control strategies for dementia.

Based on Global Burden of Disease (GBD) data from 1990-2023, trends were analyzed using Joinpoint regression, and age-period-cohort (APC) models were applied to decompose age, period, and cohort effects.

Between 1990 and 2023, the number of deaths and DALYs of ADRD attributable to smoking in China increased by 269.002% and 223.932%, respectively. During the same period, the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) showed a slight overall decline, with average annual changes of-0.135% and-0.040%, respectively. Age effect: Disease burden increased significantly with age, rising more slowly after 60 years but remaining at high levels. Period effect: Risk of disease burden continued to increase over time, peaking between 2020 and 2023. Cohort effect: A significant intergenerational decline was observed, more pronounced among females.

Although the age-standardized burden of ADRD attributable to smoking in China has gradually decreased, the absolute burden has increased, with males bearing a significantly higher burden than females. The cumulative effect of long-term smoking before age 60 has markedly increased disease burden, laying the foundation for a peak in older age, highlighting the importance of early-and mid-life interventions. Multi-level strategies, including policy measures, community support, and individual behavior interventions, should focus on middle-aged and older male smokers to reduce long-term disease burden.

To systematically analyze the spatial and temporal evolution patterns of five Category B respiratory infectious diseases (pulmonary tuberculosis (PTB), scarlet fever, measles, meningococcal meningitis (MM) and pertussis) in China (2004-2020) to guide regional prevention strategies.

Based on the National Notifiable Disease Reporting System (NNDRS) data, we integrated spatial autocorrelation analysis, center of gravity migration model and standard deviation ellipse method for multi-dimensional spatio-temporal modelling to reveal the migration paths and clustering characteristics of the morbidity hotspots.

The incidence rates of PTB and MM continued to decline, which measles showed a fluctuating decline. scarlet fever and pertussis rose significantly after 2016, with a tendency to make a comeback. The high-high clustering areas of PTB and measles migrated to the northwest. Scarlet fever showed a northward return, with the high-high clustering stable and locked in Inner Mongolia after 2018 (Moran I=0.354, P<0.01). Pertussis hotspot area shifted southward, and the high-high clustering area focused on Xiang-qian junction in 2020. The incidence of MM continued to be low and spatial aggregation disappeared.

These diseases exhibit westward migration and northward return, necessitating targeted control systems in northwestern China, optimized mobile population monitoring and vaccine persistence strategies.

To monitor the epidemiological dynamics of influenza in Guizhou Province from 2022 to 2025 and analyze the resistance of influenza A (H1N1) pdm09 subtype viruses to neuraminidase inhibitors, so as to provide evidence for influenza prevention and control as well as clinical drug therapy.

Influenza-like illness (ILI) surveillance data from sentinel hospitals within Guizhou Province's national influenza surveillance network (2022—2025) were collected and analyzed using descriptive methods. Sixty-four influenza A (H1N1) pdm09 subtype viruses isolated and identified in Guizhou Province from 2022 to 2025 were selected. A fluorescence-based luminescence assay was employed to perform phenotypic drug resistance testing on the selected influenza viruses, and the changes in drug susceptibility to oseltamivir and zanamivir were analyzed. NA gene sequencing of the influenza strains was carried out, and bioinformatics software was used to analyze the amino acid site mutations of relevant drug-resistant genes.

Between 2022 and 2025, influenza viruses in Guizhou Province exhibited an alternating or co-circulation epidemic pattern. All 64 isolated A (H1N1) pdm09 subtype influenza virus strains were sensitive to oseltamivir and zanamivir. The mean IC₅₀ value for oseltamivir was 0.448 nmol/L (range: 0.126–1.013 nmol/L), and for zanamivir, it was 0.308 nmol/L (range: 0.112–0.855 nmol/L). Sequencing was performed on the NA genes of 46 A (H1N1) pdm09 strains. All sequenced viruses were classified into clade 6B.1 and were interspersed on the phylogenetic tree without forming distinct clusters. No mutations were identified at the enzyme active catalytic sites or known resistance sites in the NA gene.

From 2022 to 2025, influenza viruses in Guizhou Province showed an alternating or co-circulation pattern. The A (H1N1) pdm09 subtype remained sensitive to oseltamivir and zanamivir, supporting the continued clinical use of this drug class.

To investigate sleep problems among middle-aged and elderly individuals from ethnic regions in Yunnan Province, China, to identifiy associated factors, and to inform targeted interventions that improve their sleep quality.

Sleep problems were defined as the occurrence of any of the following: (1) rhythm disorders (e.g., late bedtime, early or late waking); (2) insomnia (e.g., difficulty falling asleep, frequent awakenings, nocturia, or <7 hours’ sleep); or (3) hypersomnia (≥9 hours’ sleep). We conducted a stratified random cluster survey among adults aged≥45 years in 9 prefectures/cities in Yunnan Province. Data on sleep, demographics, physical/mental health, behaviors, and social relationships were collected via a self-developed questionnaire. Logistic regression identified associated factors.

Among 5 180 middle-aged and elderly adults, 76.5% reported sleep problems: insomnia (63.8%), rhythm disorders (36.4%), and hypersomnia (21.3%). The Yao group had the highest rates of insomnia and rhythm disorders; the Lisu group had the highest hypersomnia rate. Logistic regression revealed that women from the Jinuo, Lisu, Wa, Nu, and Bulang groups were significantly more likely to report sleep problems (all P<0.05). Chronic conditions increased likelihood of sleep problems in the Han, Jinuo, Yi, and Lisu groups; frequent pain increased likelihood in the Han, Hani, Zhuang, Yao, Jinuo, Yi, and Bulang groups; depressive symptoms increased likelihood in the Han, Yao, Jinuo, Lisu, Lahu, Wa, Nu, and Bulang groups; lack of social activity in the past 30 days increased likelihood in the Han, Hani, Dai, and Yao groups; and daily smoking was associated with lower likelihood in the Han, Yi, Lisu, and Bulang groups (all P<0.05).

Sleep problems are highly prevalent among the middle-aged and elderly individuals in ethnic regions of Yunnan Province. A multitude of factors, including chronic diseases, pain, depression, and health behaviors, are interrelated. It is imperative to develop precise and differentiated sleep intervention strategies in conjunction with the demographic characteristics and health indicators of ethnic groups.

In order to better understand the current situation of malaria epidemic in Suzhou and provide scientific basis for formulating targeted strategies and measures to prevent the re transmission of malaria.

Statistical description of the prevalence and distribution characteristics of malaria cases reported in Suzhou City from 2005 to 2024, the comparison of rates or proportions was performed using the chi-square test or Fisher's exact test.

From 2005 to 2024, a total of 629 cases of malaria were reported in the city, including 456 domestic cases and 173 imported cases from abroad; Before 2011, the case reports were mainly domestic cases, and since 2012, all case reports have been imported cases from abroad and no secondary cases have occurred. The peak of domestic cases is concentrated from July to October in summer, while the seasonal characteristics of imported cases are not obvious, and the difference is statistically significant (χ²=110.335, P<0.05). The top three regions with the highest number of domestic cases are Kunshan, Changshu, and Gusu, while the top three regions with the highest number of imported cases are Zhangjiagang, Gusu, and Xiangcheng. The distribution differences between regions are statistically significant (χ²=144.831, P<0.05). The gender ratio of domestic cases is 1.49: 1, and the age of patients is mainly concentrated between 20-59 years old. There is no statistically significant difference in the gender ratio between patients in different age groups (0-19 years old, 20-39 years old, 40-59 years old, ≥60 years old, the same below)(χ²=2.044, P>0.05); The gender ratio of imported cases is 20.6: 1, and the age distribution is mainly concentrated between 20-59 years old. The number of male patients in each age group is higher than that of females, and the proportion of male patients in the 40-59 age group is the highest (98.77%), which is statistically significant compared with other age groups (χ²=9.918, P<0.05). The main categories of domestic case populations are migrant workers, laborers, and farmers; The main categories of imported cases are workers, farmers, domestic workers and unemployed individuals, and commercial services. The main species composition of domestic cases is Plasmodium vivax (379/456); The main species composition of imported cases is Plasmodium falciparum (125/173). The vast majority of imported cases come from African countries.

Although malaria has been eliminated in Suzhou, imported cases from abroad continue to occur sporadically, we should improve the diagnosis and treatment level of cases, strengthen epidemic monitoring and case management, and enhance the self-protection awareness of key populations against malaria.

This study aims to examine the relationship between indoor ventilation frequency and depression levels among older adults, and further test the mediating effects of anxiety and self-rated health in this relationship, as well as the chained mediating pathways.

Using data from the 2018 China Longitudinal Health and Longevity Study (CLHLS), older adults aged≥60 years were selected as the study subjects, resulting in a final sample of 10 306 participants. Depression levels were measured using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). Anxiety status was assessed via the 7-item Generalized Anxiety Disorder Scale (GAD-7). The relationship between indoor ventilation frequency and depression levels in older adults was examined, with further investigation into the mediating effects of anxiety and self-rated health on this relationship.

Indoor ventilation frequency showed significant negative correlations with both anxiety and depression levels (r=-0.062, P<0.01; r=-0.163, P<0.01), but a significant positive correlation with self-rated health (r=0.067, P<0.01). Anxiety was negatively correlated with self-rated health (r=-0.276, P<0.01) and significantly positively correlated with depression levels (r=0.529, P<0.01); self-rated health was significantly negatively correlated with depression levels (r=-0.444, P<0.01). The direct effect of indoor ventilation frequency on depression levels in the elderly was statistically significant (effect size=-0.327, 95%CI: -0.374--0.280, Bootstrap samples=5 000); Mediation factors played a statistically significant mediating role between indoor ventilation frequency and depression levels in the elderly (effect size=-0.013, 95%CI: -0.020--0.007, Bootstrap samples=5 000).

Increasing indoor ventilation frequency not only directly improves depression levels among the elderly but also indirectly influences depression through anxiety and self-rated health. Enhancing ventilation frequency alleviates anxiety symptoms and improves self-rated health, thereby effectively reducing depression levels in the elderly.

To investigate the association between altitude and the prevalence of hypertension among residents of Tibet, and to analyze potential mediating factors.

Residents aged 18 and above who had lived in Tibet for 6 months or longer were selected through a multi-stage stratified cluster random sampling method to participate in questionnaire surveys, physical measurements, and laboratory tests. Multivariable logistic regression was employed to explore the association between altitude and hypertension. The mediating roles of hemoglobin were further analyzed.

A total of 3 085 participants were included, among whom 1 062(34.42%) were diagnosed with hypertension. After adjusting for covariates, the multivariable logistic regression showed that for every 1 000 m increase in altitude, the risk of hypertension increased by 42% (OR=1.42, 95%CI: 1.16-1.73, P<0.05). Compared with residents living at altitudes below 3 500 m, those at 3 500-<4 000 m and≥4 000 m had ORs of 1.37 and 1.61 for hypertension risk, respectively, with a significant linear trend (P for trend <0.05). Mediation analysis indicated that hemoglobin significantly mediated the association between altitude and hypertension, with mediation effect proportions of 17.80% (95%CI: 3.10%-32.60%, P<0.05).

Altitude is positively associated with the risk of hypertension among residents in Tibet. It is recommended to strengthen the monitoring of blood pressure and hemoglobin levels in populations living at high altitudes, in order to reduce the risk of hypertension.

Analyzing and evaluating the association between estimated glucose disposal rate (eGDR) and metabolic syndrome (MetS) among coal miners.

A cross-sectional study design was employed, with 8 102 employees from coal mining groups who underwent occupational health examinations in 2023 serving as the study subjects. Individual eGDR values were calculated based on waist circumference, hypertension status, and glycated hemoglobin levels, with MetS defined according to the criteria outlined in the Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes (2020 Edition). Unconditional logistic regression models and restricted cubic spline (RCS) models were employed to investigate the association and dose-response relationship between eGDR and MetS, whilst also analyzing the interaction between eGDR and occupational factors on MetS.

The mean age of enrolled employees was (48.7±5.4) years, with 2 932 individuals diagnosed with MetS (prevalence: 36.1%). Fully adjusted unconditional logistic regression analysis revealed that each standard deviation increases in eGDR (SD=2.23) reduced the risk of MetS to 0.52. The high eGDR group exhibited significantly lower MetS risk than the low eGDR group (OR=0.01), with no significant evidence of occupational factor interaction. RCS modeling revealed a strong nonlinear negative dose-response relationship between eGDR and MetS prevalence (P<0.001).

Among coal miners, eGDR exhibits a significant association with Mets, presenting a non-linear negative dose-response relationship, and no occupational factor interactions have been identified.

To investigate the impact of urban community built environments on residents' quality of life, and offer empirical support for health-oriented urban planning.

This study employed a multi-stage random cluster sampling method to survey the permanent residents in 1 401 households across 26 communities and 49 residential areas. Based on the research objectives, 2 086 adult participants were included for analysis. The study integrated multi-source geospatial data and utilized linear mixed-effects model to investigate the association between the built environment and residents' quality of life.

The mental component summary (MCS) score of residents was 49.16±11.58, and the physical component summary (PCS) score was 49.99±10.12. Linear mixed-effects model results showed that green view index (β=2.428, P<0.05), motor vehicle ratio (β=3.180, P<0.05), public transport stop density (β=2.113, P<0.05), road intersection density (β=2.854, P<0.05) and park green space ratio (β=3.048, P<0.01) were positively correlated with MCS; road network density (β=-2.963, P<0.01) and floor area ratio (β=-3.075, P<0.05) were negatively correlated with MCS. For PCS, green view index (β=1.154, P<0.05), motor vehicle ratio (β=2.197, P<0.01) and building density (β=2.018, P<0.05) were positively correlated, while floor area ratio (β=-1.761, P<0.05) was negatively correlated. Additionally, road network density interacted with building density (β=0.979, P<0.05) and green view index (β=-1.112, P<0.05) in affecting PCS.

The built environment of urban communities is closely linked to residents' quality of life. In urban spatial governance, emphasis should be placed on the systematic optimization and synergistic enhancement of various built environment elements to promote community residents' well-being.

To investigate the contamination status of Listeria monocytogenes in commercial food in Hainan province and characterize the antimicrobial resistance of the isolated strains. This study aims to provide baseline data for foodborne L. monocytogenes surveillance and scientific evidence for the prevention and control of listeriosis.

From 2015 to 2024, 8 878 commercial food samples were collected in Hainan Province and screened for L. monocytogenes. Thirty strains isolated from 2019 to 2024 underwent whole genome sequencing, and 26 were tested for antimicrobial susceptibility.

A total of 38 L. monocytogenes strains were detected in this study, and the positive rate of 0.43%. The highest annual rate occurred in 2022 (1.29%, 15/1 160), and the peak seasonal rate was in the second quarter (0.91%, 24/2 639). Geographically, Baisha County (1.48%, 2/135) showed the highest rate. Among food categories, meat and meat products exhibited the highest contamination (1.06%, 22/2 072). Retail processing stores had highest facility-level rate (1.67%, 2/120), while the circulation stage showed the highest rate among sampling links (0.49%, 33/6 783). Antimicrobial susceptibility testing identified one L. monocytogenes isolate with dual resistance to tetracycline and erythromycin. All other isolates were susceptible to all tested antibiotics. Lineage II predominate (66.67%, 20/30), with serogroup IIA as the most common type (50.0%, 15/30). ST8 was the predominant sequence type (20.0%, 6/30). All strains carried the virulence island LIPI-1, and 56.7%(17/30) strains carried the stress survival island SSI-1.

L. monocytogenes is present in meat, meat products and other foods in Hainan Province at a low overall contamination. ST8 is the predominant sequence type, and the isolates remains largely susceptible to antibiotics. These findings highlight the need to enhance monitoring of food contamination, particularly in meat and meat products, to detect potential hazards early and track evolving antimicrobial resistance pattern for effective listeriosis prevention and control.

To analyze the association between maternal and to offspring taste sensitivity and examine the moderating effect of gestational diabetes mellitus (GDM) in this relationship.

A total of 106 mother-child pairs were recruited, including 46 GDM mothers. Taste sensitivity for sweet, sour, and salty tastes was measured using sensory threshold tests. Statistical analyses included ordinal logistic regression and Spearman rank correlation.

After adjusting for relevant confounders, significant positive correlations were found between maternal and offspring sensitivity for sweet, sour, and salty tastes. Specifically, each one-level increase in maternal sweet taste sensitivity was associated with an odds ratio (OR) of 7.19 (95% CI: 2.78-19.9) for the offspring having a higher level of sweet taste sensitivity. Further stratified analysis revealed that GDM status significantly modified the intergenerational transmission of sweet taste sensitivity (between-group difference P=0.024), indicating a stronger mother-offspring association in the GDM group. Covariance analysis further revealed a specific moderating trend of GDM status in the sweet taste sensitivity association, although this effect did not reach the conventional level of statistical significance (P=0.104).

Intergenerational associations of taste sensitivity for sweet, salty, and sour tastes exist between mothers and their offspring, and the metabolic state of GDM may potentiate the transmission of sweet taste sensitivity. These findings provide new evidence supporting the mechanism of intergenerational transmission in early-life taste development.

To understand the adversity beliefs of adolescents and their parents, and to explore the impact of parental adversity beliefs on adolescents' adversity beliefs and non-suicidal self-injury.

Data were derived from the fourth round of the Chengdu Children's Positive Development Cohort. Adversity Beliefs Scale and Deliberate Self-Harm Inventory were used for on-site surveys to collect 4 994 valid paired samples of adolescents aged 8-19 and their parents. Differences in adversity beliefs between adolescents and their parents were analyzed, and the mediating role of adolescents' adversity beliefs under the moderation of parents' educational level was tested using SPSS PROCESS.

(1) The detection rate of NSSI among adolescents was 22.33%, and there are differences in the incidence of NSSI among adolescents under different demographic characteristics; (2) Parental adversity beliefs (r=-0.168, P<0.01) and adolescents' adversity beliefs (r=-0.329, P<0.01) were negatively correlated with NSSI behavior, while parental adversity beliefs were positively correlated with adolescents' adversity beliefs (r=0.293, P<0.01); (3) Adolescents' adversity beliefs played a partial mediating role in the impact of parental adversity beliefs on NSSI behavior, accounting for 52.76% of the total effect; (4) The parents' education level significantly moderates the effect of their adversity beliefs on adolescents' adversity beliefs (β=-0.064, P<0.01).

Adversity beliefs have an intergenerational transmission effect. Parental adversity beliefs influence adolescents' NSSI behavior through intergenerational transmission. Targeted measures can be implemented from the perspective of intergenerational relationships to reduce the occurrence of adolescents' NSSI behavior.

To analyze the prevalence of elevated blood pressure and its associated factors among children and adolescents aged 6-17 years in Fujian Province.

Data were derived from the 2022 Fujian Provincial Project of the China National Nutrition and Health Surveillance. A total of 1 722 children and adolescents aged 6-17 years were selected using a multi-stage stratified cluster random sampling method. Data were collected through standardized questionnaires, physical measurements, and laboratory tests. Multivariate logistic regression was used to analyze the influencing factors of elevated blood pressure.

The detection rates of prehypertension and elevated blood pressure were 11.4% and 11.0%, respectively. Among the types of elevated blood pressure, the detection rates for isolated systolic hypertension, mixed hypertension, and isolated diastolic hypertension are 4.9%, 3.7%, and 2.4%, respectively, with isolated systolic hypertension being the most prevalent. Multivariate logistic regression analysis showed that the independent risk factors for elevated blood pressure in children and adolescents included overweight (OR=2.147, 95%CI: 1.435-3.212), obesity (OR=2.688, 95%CI: 1.757-4.112), hypertriglyceridemia (OR=1.554, 95%CI: 1.029-2.346), and vitamin D deficiency (OR=1.777, 95%CI: 1.037-3.047).

Elevated blood pressure is relatively common among children and adolescents in Fujian Province, with isolated systolic elevation being the predominant pattern. Its occurrence is significantly associated with overweight/obesity, hypertriglyceridemia, and vitamin D deficiency. A comprehensive prevention and control strategy is recommended that centers on weight management, while also addressing lipid metabolism and vitamin D nutritional status, thereby providing a scientific basis for the early prevention of cardiovascular diseases.

To evaluate the “Township Recruitment and Village Utilization” policy in Nanning, examining its effects, challenges, and the role of policy instrument allocation.

We constructed a “policy instruments–policy goals” framework to analyze 21 policy documents (policy dimension). Findings were triangulated with a survey of 2 689 village doctors and in-depth interviews with 35 (empirical dimension).

A structural imbalance was found: environmental instruments (46.2%) focused predominantly on standardized management (57.1%), while demand-side instruments were underutilized (21.8%). Only 31.0% of village doctors were satisfied with their compensation, and 21.0% with career prospects. Frequent issues included drug shortages, promotion difficulties, and delayed performance payments.

The policy-empirical analysis reveals a systemic dilemma of “excessive management versus deficient incentives” due to imbalanced policy tools. Optimizing the policy mix, establishing a dynamic drug supply system, and improving career pathways are recommended.

To identify latent classes of traditional Chinese medicine (TCM) health literacy among Chinese residents and examine influencing factors, in order to inform targeted promotion strategies.

A combined stratified and typical sampling approach was used to survey 1 259 residents from Hangzhou, Hefei, and Sanming. Latent profile analysis (LPA) identified TCM health literacy classes, and logistic regression analyzed influencing factors.

Residents' TCM health literacy has reached 57.9%. Four latent classes were identified: knowledge-belief separation (18.6%), basic deficiency (29.4%), balanced literacy (34.3%), and ideal exemplary (17.7%). Significant influencing factors included age, monthly income, medical payment method, self-rated health, and awareness of TCM health service and insurance reimbursement.

There is significant group heterogeneity in TCM health literacy among Chinese residents. An intervention system covering policy guidance, community implementation and individual participation is required, featuring differentiated strategies based on knowledge popularization, belief cultivation, behavior transformation and role modeling, so as to foster overall improvement in TCM health literacy.

To analyze the impact of DRG policy on the medical cost and service efficiency of patients with esophageal cancer, and to provide reference for further improvement of medical services.

Case data of patients with esophageal cancer treated by surgery in five pilot hospitals undergoing DRG policy in Changzhi, Shanxi Province, were collected from January 2019 to June 2023 to analyze the changes in patients' medical costs and hospitalization days before and after the implementation of DRG, and an interrupted time series (ITS) model was established to analyze the impact of the DRG reform.

ITS results indicate that compared to the period before the implementation of the DRG policy, medical expenses for esophageal cancer patients decreased by 12 089 CNY (P<0.05). The intervention instantaneous intercept showed a significant decline and exhibited a sustained downward trend (P<0.05). Hospitalization days decreased by 5 days (P<0.05), with the intervention instantaneous intercept decreasing, though the long-term downward trend was not significant (P=0.176). Within the medical cost structure, the intervention instantaneous intercepts for general medical service fees, diagnostic examination fees, non-surgical treatment fees, surgical fees, and Western medicine fees all decreased. Diagnostic examination fees, non-surgical treatment fees, and Western medicine fees exhibited a long-term downward trend (P<0.05). Conversely, the intervention-specific intercepts for nursing fees, anesthesia fees, and consumables fees all increased, with consumables fees showing the most significant rise. After the reform, consumables fees increased by 9 185 CNY (P<0.05) and exhibited a long-term upward trend (P<0.05).

The DRG policy can alleviate patients' financial burden and enhance the service efficiency of healthcare institutions. It is recommended to further deepen the long-term mechanism of DRG in controlling overall costs and innovate clinical management models; strengthen the supervision of pharmaceuticals and medical consumables; elevate the value of labour and technical services; advance payment method reforms; and improve supporting systems compatible with DRG reform.

To explore the coupling and coordination relationship between medical service price and social economic development in Sichuan Province, and provide references for deepening medical service price reform and promoting regional linkage and coordinated development.

The coupling coordination degree model was used to evaluate the coupling coordination degree between medical service price and social economic development, and the coupling coordination grade and type were clarified.

From 2017 to 2022, the coupling coordination degree between medical service price and social economic development in Sichuan Province showed an upward trend. Among the five economic regions, only the coupling coordination degree of Northwest Sichuan Ecological Demonstration Zone showed a downward trend, while the other four regions showed an upward trend. Specifically speaking, Chengdu ranked first in coupling coordination degree, belonging to intermediate coordination, while Ganzi and Aba were at the end, belonging to serious imbalance. From high to low, the proportion of coupling coordination type was lagged medical service price type, synchronized medical service price and social economic development type, lagged social economic development type.

The coupling coordination trend of the two systems in Sichuan Province is generally good, but the coordination degree is not high, and there are significant regional differences. Generally, it belongs to the lag coordination of medical service prices.

To understand the chain-mediating role of health literacy and self-efficacy in the relationship between social support and health-promoting behaviors among older adults.

From September to December 2024, a multi-stage random sampling method was adopted to conduct a questionnaire survey among 1 152 elderly individuals aged 60 and above in Shandong Province. Pearson correlation analysis was used to analyze the correlations among social support, health literacy, self-efficacy, and health-promoting behaviors. Using SPSS software and its PROCESS plug-in, a chain mediation model was constructed to analyze the mediating effects of health literacy and self-efficacy in this relationship, with significance tested via the Bootstrap method.

The direct effect of social support on health-promoting behaviors was significant (β=0.586, 95%CI: 0.503-0.669). The mediating effect of health literacy between social support and health-promoting behaviors was significant, with an effect value of 0.138 (95%CI: 0.100-0.179). The mediating effect of self-efficacy between social support and health-promoting behaviors was significant, with an effect value of 0.125 (95%CI: 0.087-0.167). The chain-mediating effect of health literacy and self-efficacy between social support and health-promoting behaviors was significant, with an effect value of 0.076 (95% CI: 0.053-0.104).

Social support has a positive predictive effect on the health-promoting behaviors of older adults. Social support indirectly influences the health-promoting behaviors of older adults through health literacy and self-efficacy.

To explore the relationship between the healthy eating index (HEI) and falls and injuries from falls in older adults.

Data from the 2018 Chinese Longitudinal Healthy Longevity survey and happy family study (CLHLS-HF, wave 2018) were used. HEI scores were calculated based on the consumption frequency of 13 food categories collected through face-to-face interviews. Fall events and fall injuries were based on self-reports. Multivariate logistic regression and restricted cubic spline (RCS) analysis were used to analyze the association between HEI and falls and fall injuries. Confounding factors were adjusted and subgroup analyses were performed.

A total of 8 701 older adults aged 65 years and above were included in this study. After adjusting for potential confounding variables, HEI was significantly negatively correlated with falls (OR=0.98, 95%CI: 0.97-0.99) and fall injuries (OR=0.97, 95%CI: 0.96-0.98). RCS analysis showed a linear dose-response relationship between HEI and falls (P overall<0.001, P for non-linearity=0.208) and fall injuries (P overall<0.001, P for non-linearity=0.059). Subgroup analysis showed that this association remained significant in men (P trend=0.032), women (P trend=0.002), individuals aged 80 years and older (P trend<0.001), and non-living-alone elderly (P trend<0.001).

Higher HEI levels among the elderly in China are associated with a reduced risk of falls and fall injuries. Paying attention to HEI levels may help the early identification of high-risk groups for falls, providing new ideas for the early prevention and intervention of falls in the elderly.

To explore nonlinear effect of BMI and sleep duration on the risk of self-reported pain in Chinese elderly and explore their potential interactions.

The cohort study was conducted based on the Chinese health and retirement longitudinal study (CHARLS). Piecewise linear splines modeled nonlinear exposures, and competing risk models (Fine-Gray) analyzed associations between BMI, sleep duration, and self-reported pain, after adjusting for demographic characteristics, lifestyle factors, and health status with all-cause death as competing event.

Total of 4 409 elderly individuals were included, with a median follow-up of 3.1 years. During follow-up, 1 521 participants (34.50%) reported pain occurrence, and 199 (4.51%) died. Both underweight (BMI<20.0 kg/m²) and overweight/obese (BMI>26.9 kg/m²) were associated with a significantly increased short-term risk of pain (β=5.447, P<0.001; β=3.582, P<0.001), which gradually decreased over time (β=-1.436, P<0.001; β=-0.960, P<0.001). Similarly, short sleep (<6 hours) and long sleep (>9 hours) were associated with an elevated short-term pain risk (β=5.516, P<0.001; β=8.771, P<0.001), with the risk diminishing over time (β=-1.448, P<0.001; β=-2.354, P<0.001). Notably, long sleep duration exhibited the strongest effect. Interaction analysis revealed negative multiplicative interactions at baseline for underweight with short sleep (β=-1.953, P<0.001), overweight/obesity with short sleep (β=-1.326, P<0.001), and overweight/obesity with long sleep (β=-1.612, P<0.001), indicating that the short-term pain risk in these combined-risk groups was lower than the sum of their individual effects. However, time-interaction analysis showed that the pain risk in these combined-risk groups declined significantly slower over time compared to those with single risk factors (β=0.521, P<0.001; β=0.355, P<0.001; β=0.435, P<0.001), suggesting more persistent pain and slower recovery.

Abnormal BMI and abnormal sleep duration are significantly associated with an increased risk of pain requiring medication intervention in the Chinese elderly population, with long sleep duration showing the strongest association. Complex synergistic effects exist between abnormal weight and sleep problems: although combined-risk groups do not exhibit additive short-term pain risk, they experience prolonged pain duration and slower recovery, making them a high-risk population for pain chronification.

Based on the broad-spectrum targeted lipid group and metabolomics technology, the mechanism of citric acid (CA) antagonizing benzo[a]pyrene (B[a]P)-induced renal injury in mice was explored, which provided a new idea for the intervention of renal injury after B[a]P exposure.

Forty-eight healthy 4-week-old male C57BL/6 mice were randomly allocated into six groups, namely the control group, low/medium/high-dose B[a]P groups (2.5, 5, 10 mg/kg), citric acid group (400 mg/kg), and high-dose B[a]P+citric acid group, with 8 mice per group. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was employed for the detection of broad-spectrum targeted lipid profiling and metabonomics in renal tissues, and the contents of serum creatinine, serum uric acid and blood urea in renal samples were quantified. Pathological changes of the kidney were examined using HE staining.

The concentrations of creatinine, uric acid and urea in the kidney of the exposed mice increased (represented by peak area), and the urea concentration in the high-dose group (3 935 000±1 043 140.86) was significantly higher than that in the control group (2 706 250±385 484.39) (P<0.05). The renal pathological results of B[a]P exposure group were damaged, and the high-dose damage was serious. Compared with the control group, a total of 114 differential metabolites were identified in the kidney tissues of mice in the B[a]P high exposure group, which were mainly enriched in 32 metabolic pathways such as arachidonic acid, glutathione, and sphingolipids. After the intervention of citric acid, the renal creatinine, uric acid and urea concentrations in the high-dose B[a]P+citric acid group (10 625 750±6 541 890.63, 1 042 907.5±692 189.5, 1 849 501.25±1 150 570.62) were significantly lower than those in the high-dose group (19 150 000±3 523 796.65, 1 985 000±363 396.67, 3 935 000±1 043 140.86) (P<0.05), and the renal pathological damage was improved. Further omics studies showed that 106 differential metabolites were identified in the high-dose B[a]P+citric acid group compared with the high-dose B[a]P group, and 48 significantly reversed metabolites such as leukotriene B4, 15-hydroxyeicosatetraenoic acid, hydroxyproline, indoxyl sulfate, corticosterone, cytidine, guanylate and coenzyme Q10 were found in the intersection of differential metabolites in the high-dose B[a]P group. It was mainly enriched in arachidonic acid metabolism, steroid hormone biosynthesis, histidine, glutathione, arginine and proline, primary bile acid biosynthesis, taurine and hypotaurine, pyrimidine, purine, tyrosine, sphingolipid and unsaturated fatty acid biosynthesis and other metabolic pathways.

Citric acid can antagonize subchronic B[a]P-induced renal injury in mice by inhibiting inflammatory response, enhancing antioxidant capacity, regulating hormone and bile acid levels such as aldosterone and cortisol, and repairing energy and lipid metabolism homeostasis.

To investigate whether trichlorfon exposure induces hepatic injury and lipid accumulation by downregulating IRX5 expression.

Male SD rats were randomly divided into control, low-dose (10 mg/kg), and high-dose (25 mg/kg) trichlorfon gavage groups and exposed for 30 days. Serum liver function (ALT, AST) and blood lipids (TG, TC) were detected; liver histopathology and hepatocyte apoptosis were observed by H&E and TUNEL staining; RT-qPCR and Western Blot were used to detect the expression of inflammation, apoptosis, lipid metabolism-related genes, and IRX5; molecular docking was performed to predict the binding between trichlorfon and IRX5. In vitro experiments were conducted using HepG2 cells as a model, with 200 μM determined as the subtoxic concentration. Cells were divided into control, 200 μM trichlorfon treatment, and 200 μM trichlorfon combined with IRX5 overexpression (OE-IRX5) groups. Intracellular lipid droplets were observed by Oil Red O staining, cell viability was evaluated by CCK-8 assay, and lipid metabolism key proteins were detected by Western Blot.

Compared with the control group, the trichlorfon treatment group showed decreased body weight (P<0.001), significantly increased serum ALT, AST, TG, and TC levels (P<0.000 1); liver tissue exhibited inflammatory damage, increased hepatocyte apoptosis, upregulated lipid metabolism-related gene expression (P<0.001), and downregulated IRX5 expression (P<0.01). Molecular docking showed that the binding energy between trichlorfon and IRX5 was-7.43 kcal/mol. In vitro experiments, 200 μM trichlorfon induced lipid droplet accumulation and downregulated IRX5 (P<0.05); IRX5 overexpression significantly reduced lipid accumulation, partially restored cell viability, and improved lipid metabolism disorder.

Chronic trichlorfon exposure causes hepatic injury and lipid accumulation in rats, potentially through downregulation of IRX5 expression. These findings implicate IRX5 as a critical mediator in trichlorfon-induced hepatotoxicity and metabolic disruption.

To analyze the epidemiological characteristics of mushroom poisoning in Guizhou Province from 2017 to 2024. To compare the predictive performance of the Seasonal Autoregressive Integrated Moving Average model (SARIMA) versus the combined Seasonal Autoregressive Integrated Moving Average-Support Vector Regression (SARIMA-SVR) model in forecasting incidence trends.

Data on mushroom poisoning events from 2017 to 2024 were obtained from the Foodborne Disease Outbreak Surveillance System of Guizhou Province for descriptive epidemiological analysis. Using data from 2017 to 2023 as the training ser and data from 2024 as the testing set, SARIMA and SARIMA-SVR combined models were constructed. Model performance was evaluated using mean absolute error (MAE), mean absolute percentage error (MAPE), and root mean square error (RMSE).

A total of 2 694 mushroom poisoning outbreaks were reported during 2017 to 2024 Guizhou Province, involving 8 987 cases and 31 deaths. Mushroom poisoning is highly prevalent summer and autumn (June to September), with higher rates observed in the northeastern region. The most affected age group was 20 to 59 years, and households were primary setting of occurrence. In terms of model predictive performance, the SARIMA model could relatively well capture the overall trend of incidence, but the SARIMA—SVR combined model exhibited superior predictive performance.

Mushroom poisoning remains highly prevalent in Guizhou Province, exhibiting distinct seasonal and geographical patterns. The SARIMA-SVR combined model provides better forecasting accuracy and can serve as a valuable tool for surveillance, early warning, and preventive interventions.

To analyze the evolution of the disease burden of neck pain in China from 1990 to 2023 and to quantify the effects of age, period, and cohort.

Utilizing data from the Global Burden of Disease (GBD) 2023 study, the annual percentage change was calculated using Joinpoint regression. An age-period-cohort (APC) model was employed to analyze temporal trends in disease burden and to assess its effects.

From 1990 to 2023, the number of prevalent cases of neck pain in China increased from 266.42×10⁶ to 487.71×10⁶. The standardized prevalence increased from 2 479.65 per 100 000 to 2 504.27 per 100 000, with an AAPC of 0.037 5%. The standardized incidence rate among males declined from 491.97 per 100 000 in 1990 to 486.84 per 100 000 in 2023, corresponding to an AAPC of-0.020 7%. The standardized DALYs rate rose from 245.89 per 100 000 to 248.78 per 100 000, with an AAPC of 0.037 6%. A significant reconstruction was observed in the age distribution of disease burden: the peak age across all burden indicators shifted from 35-39 years in 1990 to 55-59 years in 2023, and the standardized rates were significantly higher in females than in males. The APC model indicated that the local drift values for the population aged over 45 years were greater than zero, reflecting a positive growth in risk. The period effect revealed that risk reached a historical high during 2019-2023.

The disease burden of neck pain in China is transitioning from a pattern of “high incidence among young and middle-aged adults” to one marked by “a shift toward older age groups” The absolute burden in terms of case numbers remains substantial due to population aging. This study is the first to elucidate the age restructuring and spatiotemporal evolution of the neck pain burden, identify middle-aged and older women and specific birth cohorts as high-risk groups. The findings provide critical evidence for informing national strategies on the prevention and control of orthopedic chronic conditions and for optimizing the allocation of healthcare resources in China.

To assess the global burden of myocarditis among individuals aged 15-49 years from 1990 to 2021 and to project disease trends up to 2050, providing a basis for prevention and control.

Based on the Global Burden of Disease (GBD) 2021 database, the assessment employed age-standardized rates, joinpoint regression, correlation analysis with the Socio-demographic Index (SDI), and a Bayesian prediction framework.

In 2021, the global age-standardized prevalence rate (ASPR) of myocarditis in this population showed an upward trend, while the age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life years (DALYs) rate decreased significantly. The burden was higher among males. The highest ASPR was observed in high-SDI regions, and the most significant mortality risk was found in middle-high SDI regions. The number of cases is projected to potentially increase by 2050, although the standardized rates are expected to continue declining.

Targeted intervention strategies for high-risk populations and regions are necessary, along with improving medical standards in low-SDI areas and reducing health inequalities through global cooperation.

To systematically compare the differences and temporal trends in the burden of lower respiratory infections (LRIs) between China and G20 countries from 2010 to 2023, and to provide scientific evidence for the formulation of targeted prevention and control strategies.

Data on incidence, mortality, and disability-adjusted life years (DALYs) of LRIs in China and G20 countries during 2010-2023 were extracted from the Global Burden of Disease (GBD) 2023 database. Statistical analysis was conducted using R software (version 4.4.2), and the estimated annual percentage change (EAPC) was calculated based on a log-linear regression model to assess time trends. Decomposition analysis was applied to quantify the contributions of population growth, population aging, and epidemiological changes to disease burden. The attributable proportions and temporal variations of major risk factors were also evaluated.

From 2010 to 2023, the burden of lower respiratory infections showed a significant downward trend in both China and G20 countries, with a faster decline observed in China for mortality and DALYs (EAPCs: -5.29 and-8.66 vs-3.17 and-4.07, respectively). Decomposition analysis indicated that epidemiological changes were the primary driver of the reduction in disease burden, while population aging and growth exerted relatively limited positive effects. Risk factor analysis revealed that air pollution and tobacco exposure were the major attributable factors. In China, the proportion attributable to ambient particulate matter pollution showed an increasing trend, whereas that attributable to household solid fuel pollution decreased significantly. Children (<5 years) and older adults (≥75 years) were identified as the key populations bearing the disease burden, with males having a slightly higher burden than females.

The burden of lower respiratory infections in China has declined more rapidly than the G20 average; however, the impacts of ambient particulate matter pollution and tobacco exposure have become increasingly prominent. Strengthening air quality management and tobacco control measures, with particular focus on protecting children and the elderly, is essential to further reduce the disease burden.

To investigate the longitudinal association between long-term levels of the C-reactive protein-triglyceride-glucose index (CTI) and changes in sarcopenia status among middle-aged and older adults in China.

This study was based on data from the baseline survey and the second follow-up of the China Health and Retirement Longitudinal Study (CHARLS). Long-term CTI levels were characterized using k-means clustering-derived categories and cumulative CTI. Changes in sarcopenia status were defined according to sarcopenia status at baseline and at follow-up. Multivariable logistic regression models were used to examine longitudinal associations. Stratified analyses were performed, and dose–response relationships were assessed using restricted cubic spline models.

A total of 3 377 middle-aged and older participants who met the inclusion and exclusion criteria were included in the analysis. K-means clustering classified long-term CTI levels into three groups: persistently low, persistently moderate, and persistently high. Compared with the persistently low CTI group, individuals with persistently high CTI levels had a significantly higher risk of sarcopenia progression (OR=1.66, 95%CI: 1.07~2.57; P<0.05), with generally consistent directions across subgroups. Using the median cumulative CTI (14.29) as the reference, the risk of sarcopenia progression initially decreased and then increased with increasing cumulative CTI, with a elevation in risk within the range of 15~17. The highest risk was approximately 1.53 times that of the reference value (OR=1.53, 95%CI: 1.17~1.99; P<0.05).

Among middle-aged and older adults in China, persistently high long-term CTI levels are associated with an increased risk of sarcopenia progression, providing epidemiological evidence to support the prevention of the onset and progression of sarcopenia.

To evaluate the efficacy of dance therapy for patients with dementia, and to provide evidence-based guidance for developing clinical intervention protocols.

A comprehensive search was conducted across Chinese and English databases including CNKI, Wanfang, PubMed, and Embase for randomized controlled trials on dance therapy in patients with dementia. The search covered the period from database inception to April 30, 2025. Meta-analysis was performed using RevMan 5.3 software.

Meta-analysis revealed that dance therapy improved the Mini-Mental State Examination score (MD=1.05, P<0.001), Montreal Cognitive Assessment score (MD=2.09, P<0.001), and Wechsler Logical Reasoning Test scores (MD=2.54, P<0.001). It also reduced Geriatric Depression Scale scores (SMD=-0.49, P<0.001) and activities of daily living scores (SMD=-0.59, P=0.04).

Current evidence suggests that dance therapy may improve cognitive function, reduce depression, and enhance activities of daily living in patients with dementia. Given the quality and quantity of the studies, further high-quality research is needed to substantiate these findings.

To investigate the association between very-low-density lipoprotein cholesterol (VLDL-C) and its components with atherosclerotic cardiovascular disease (ASCVD) risk in long-term breast cancer survivors.

This study included 2 333 female participants with a history of breast cancer diagnosed at least 3 years before baseline in the UK Biobank. Cox proportional hazards models were used to assess the associations of VLDL-C and its components, cholesteryl ester (VLDL-CE) and free cholesterol (VLDL-FC), with ASCVD incidence.

During a median follow-up of 13.9 years, 238 participants developed ASCVD. Compared with the lowest quartile, participants in the highest quartile of VLDL-C had a 61% higher risk of ASCVD (HR=1.61, 95%CI: 1.09-2.37). Similar associations were observed for VLDL-CE and VLDL-FC, with a stronger effect for VLDL-FC. Subgroup analyses revealed that the association between VLDL-C and ASCVD was more significant among participants receiving cancer treatment.

Among long-term breast cancer survivors, elevated VLDL-C and its components are positively associated with ASCVD risk, suggesting their potential as biomarkers for cardiovascular risk assessment in this population.